3 Hours in a Major Hospital

Healthcare, whether we like to think about it or not, is definitely in our present or our future. When we need care in a hospital facility, we want to go to one that is not only proficient in whatever service we may need, takes our health insurance, is well-staffed and CLEAN.

I put that “clean” in capital letters because, even if everything else falls into place, the ultimate fate of the outcome of our procedures, especially surgical, is highly dependent on cleanliness. The staff needs to pay close attention to this and so does the administration of the facility.

For much of this, we depend on an organization known as the JCAHO (Joint Commission on Accreditation of Healthcare Organizations) . The commission makes regularly scheduled rounds at hospitals and healthcare operations all over the country and, depending on their findings, funding can be kept in place or withdrawn.

Usually, the hospital (I’m going to stick to that one) gets a notice not only of the visit and who will be there, but a report of their findings afterward. Then they have a limited amount of time to correct deficiencies. Although the visits by inspectors are supposed to be “unannounced,” I sincerely doubt they are because I’ve seen hospitals pulls all hands on deck to ready themselves for a visit every three years. If they didn’t know it was coming, why would they be so in a panic and panic they do.

Some facilities of which I’ve had third-hand, uncorroborated knowledge, go so far as taking patient charts and hiding them. Employees have even taken charts home to keep them from inspection. Now that we have EHR (electronic health records), that isn’t so easy but not everyone keeps their records in that form.

Blithely unaware of how these “protections” may be compromised, we go into these places of care with blinders on, usually. I don’t think many, if any, of you whip out your cells and photograph spots that are compromised or totally deficient. How would you know “deficiencies” even if they were there? You wouldn’t and that’s what they depend on.

Every hospital facility has an “infection control” person or staff and their job is to insure that the place is ship-shape. How many of them do a slipshod job and how many are thorough? You will never know.

When you see dust bunnies under furniture in exam rooms, you know housekeeping isn’t doing a good job and doesn’t that constitute an unclean environment where people are coming for medical procedures? Yeah, it does. Layers of dust on top of fire extinguishers, too, are unclean and so are seats that are stained and bathrooms with sticky floors.

I spent three hours recently in a major hospital center that is billed as the “best cancer hospital in the nation.” No, I wasn’t there for cancer and I hope anyone who was there for cancer received very good treatment.  Take a walk with me and let me detail what I found.

Large parking garage. That’s nice except for the flock of pigeons who fly into the garage and deposit lots of poop everywhere, even outside the open doors leading to outpatient surgery floors. Surgery? Yeah, surgery where sanitation has to be preemo. Poop on the concrete attested to never having been cleaned and who knows what was flying in the air. Don’t pigeons carry a variety of airborne pathogens? Would a surgery patient coming out have to walk through an unseen cloud of this stuff? Absolutely. Wouldn’t it be especially unsafe if an incision were uncovered? Need I ask that question? You know the answer.

ADDENDUM: Walking through the pigeon droppings and the unseen cloud of bacteria carried or created by this material on the floor doesn’t end there. Patients in this outpatient surgical facility are ultimately taken into the small OR adjacent to the large waiting room. What happens then?

The next thing that happens should be shocking after what I’ve just told you. Patients are told to get up onto the OR table WITH THEIR SHOES ON! No removal of shoes beforehand, no shoe coverings, no cleaning of shoes, nothing.

Once the procedure is completed and the patient begins to climb off the table, it is clear that the unclean shoes have left a distinctive black dirt mark on the sheet beneath their feet. What is on that sheet and how was the procedure sterile if that were permitted to remain? No one seems to care.  Where does dirty linen go? Patients are too zeroed in on their just-completed procedures to look for a depository for linens.

Prior to going to the surgical holding pen, the patients walks in through the open doors from the garage and trys to figure out where to go because there wasn’t a sign indicating where the registration desk was. Find the desk and the woman begins spilling forth reasons she’s not prepared for patients. Seems she’s a supervisor and there was no one to man the desk while the person went on break. So, she doesn’t know what to do. Big help.

A trip to one of the restrooms on the outpatient surgery suite floor reveals that they are filthy and stomach-churning. Where’s housekeeping? And in a surgical unit? Shouldn’t it be spotless? Obviously not.

Immediately staffing would appear to be an issue here and that was validated later when shift change came and all the outpatient surgery bays were devoid of staff. Yup, not one nurse or nursing assistant to be found. Three o’clock appears to be the witching hour at that hospital, so god help anyone who needs help or care.

Patient coordination, too, was problematic as a nurse told a patient, “You were supposed to be here at 1:00pm and you weren’t so he took someone else. Now you’ll have to wait.” Upon being shown a hospital outpatient admission form indicating the patient was to be there at 2:00pm, not 1:00pm, the nurse said, “Well, you were supposed to be here at 12:30pm and that’s the problem.” Seems three different people provided three different times for this patient to arrive. Who’s to blame for the mix-up? The patient, of course. Why blame staff?

Almost two hours later, the patient is taken in for the simple procedure and before, during and after it the surgeon acts as though he’s bringing in the mail. No words of encouragement, no indicating what is happening during the procedure or afterward and he’s gone. Three nurses try to make up for his abrupt and ham handed beside manner.

The only words are, “Next time, don’t wait so long if this comes back.” Patient blamed again. Comes back? He said he’d take care of the problem so it wouldn’t come back again. Now it might come back?

Nurses offer words of encouragement, juice and medicine for home care and then they all leave. It’s shift change.

Back to the pigeon-infested garage with a newly stitched, uncovered wound. Great.

Note to patient: Never, never go to this hospital or this man again. If it comes back, find someone else because this guy is not someone you want to deal with again.

Special note to patient: Believe ratings on Rate My Doctor because this guy was said to have a poor beside manner and was sued by a woman surgeon. The case went to trial and the woman said she now has another problem which another surgeon has to correct.  Another woman on the site advised that you “treat him like the plague and stay AWAY from him!” Words of advice which were not heeded because others liked him and the hospital staff sang his praises loudly.

Chalk up the staff to just plain PR.